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Hair Loss in Women

Studies estimate that one in five women may suffer from some degree of hair loss due to aging, illness or hormonal changes after menopause.


  • Women lose hair in a pattern different from men. Unlike bald patches as seen commonly in men, women tend to experience a subtle thinning of the scalp all over.
  • Women often choose to wear a wig or use hair extensions to cover the hair loss. Some also use prescriptive drugs with some success. These results of these drugs vary in each patient, and they simply prevent further hair loss without fuelling any new growth.
  • A suitable alternative for those who feel uncomfortable with either of the options mentioned is the hair replacement surgery.
  • Mini-grafts are the usually the preferred technique for filling-in thinning areas and hence good candidates for this procedure should have dense hair growth at the back of the head. Grafts are collected from the dense area to be replanted in the thinning areas to create a fuller look.
  • Sometimes flap and tissue expansion procedures are also used if the patient is considered to be a suitable candidate.
  • When considering a hair replacement surgery, it is pertinent that the patient understands that the surgery may not deliver the coverage one had prior to hair loss, but may successfully conceal the thinning areas and give a fuller look.

Hair Grafting Procedure:

Before the surgery, the ‘donor area’ is trimmed short to allow easy access and removal of the grafts.

In a punch-graft, a special tube-like instrument made of sharp carbon steel punches the round graft out of the donor site to be replaced in the area to be covered i.e. normally the frontal hairline. In other grafting techniques, a scalpel is used to remove small sections of hair-bearing scalps and divided into small sections for transplantation in tiny holes or slits in the scalp.

The donor site holes may be closed with stitches-for punch grafts where a single stitch may close each punch site. A straight line scar is the resultant of the other grafting techniques. All stitches are usually concealed with the surrounding hair.

Small amounts of saline are periodically injected into the scalp to maintain proper skin strength when grafts are taken and to maintain healthy circulation in the scalp, the grafts are placed about one-eighth of an inch apart. The spaces between the plug are filled in with additional grafts in later sessions. The average numbers of large plugs transplanted in the first session are around 50, though it may vary with each individual. In mini-grafts or micro-grafts, the numbers can go up to 700 per session.

Great care is to be taken while removing and placing grafts to ensure that the transplanted hair will grow in a natural direction and that hair growth at the donor site is not adversely affected.
On completion of the grafting session, the scalp is to be cleansed and covered with gauze and the patient may be required to wear a pressure bandage for a couple of days. Some surgeries allow a bandage-free recovery.
To achieve satisfactory results, one may normally need several surgical sessions with a healing interval of several months between each session. In most cases, it takes up to two years before the final result of the full transplant series is visible.

The amount of hair coverage after hair grafting depends partly on the existing colour and texture of the patient’s hair. Coarse and grey or light-coloured hair has a better coverage than fine and dark-coloured hair. 

Tissue-expansion technique

The leaders in the tissue-expansion technique are the plastic surgeons as this a technique commonly used in reconstructive surgeries to heal fix burn wounds and injuries with major loss of skin.


  • Application of tissue-expansion in hair replacement surgery has yielded striking results with significant coverage in a relatively short amount of time.
  •  In this technique, a tissue expander which is a balloon like device is inserted beneath the hair bearing scalp that lies next to a bald area. The device is gradually inflated with salt water over a period of several weeks leading to the skin being expanded to grow new skin cells and causing a bulge beneath the hair-bearing scalp.
  • When the skin beneath the hair has stretched enough-usually about two months after the first operation-another procedure is performed to bring the expanded skin over to cover the adjacent bald area


Hair Replacement Surgery


Hair replacement surgery is a surgical procedure used to treat excessive hair loss. In a standard cycle of hair growth, it is normal for some hair to fall off every day, but sometimes one experiences excessive hair fall or hair loss.
There are many causes of such excessive hair loss. It can caused by a combination of aging; or hormonal changes; or by burns or trauma. It has been disproved that hair loss or baldness can occur due to poor circulation of blood to the scalp, deficiency of vitamins, presence of dandruff or even due to wearing hats for a long time.
 In case of hair loss by burns or trauma, hair replacement surgery is considered as a reconstructive treatment and may be covered under health insurance.
Who can have a Hair Replacement Surgery?

  • If a person has healthy growth of hair at the back and sides of the head that can serve as donor areas, he or she can    undergo a hair replacement surgery. Donor areas are the areas on the head from which grafts and flaps are taken for the surgery.
  • It is advisable that the surgery not be performed on an individual with very little hair.
  • Hair replacement surgery can enhance one’s appearance and increase the self confidence, but often the results of such a surgery may not match up to expectations.
  • Since all hair replacement techniques use existing hair, it is highly recommended that one should have realistic expectations and discuss these with the surgeon before one decides to undergo the surgery. Features such as hair color, texture and waviness or curliness may also influence the results of the surgery.


How does a hair replacement surgery work and what are the different types of procedures?

  • Various techniques are available for use in a hair replacement surgery. Often two or more techniques are combined in one surgery to achieve the optimum results.
  • Patients who wish for a modest change in hair fullness can undergo a surgery using any of the different hair grafting techniques while tissue-expansion along with flaps and scalp-reduction are the other techniques suitable for patients who need a more dramatic change.

Different techniques of Hair Grafts:

In a hair grafting technique, small pieces of hair-bearing scalp grafts from a donor site are relocated to a bald or thinning area. There are different graft techniques based on the size and shape of the grafts.


  • Punch-graft: Round-shaped grafts containing around 10-15 hairs are called punch-grafts.
  • Mini-grafts & Micro-grafts: Smaller than the punch-grafts are the mini-grafts and micro-grafts with 2-4 hairs in the former and 1-2 hairs in the latter.
  • Slit-grafts: In slit-grafts, grafts are inserted into slits created in the scalp with about 4-10 hairs each.
  • Strip-grafts: Strip grafts are long and thin strips than contact 30-40 hairs each.


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